ABM Clinical Protocol #26: Persistent Pain with Breastfeeding

Breastfeeding ◽  
2022 ◽  
pp. 978-986
Author(s):  
Pamela Berens ◽  
Anne Eglash ◽  
Michele Malloy ◽  
Alison M. Steube
2016 ◽  
Vol 11 (2) ◽  
pp. 46-53 ◽  
Author(s):  
Pamela Berens ◽  
Anne Eglash ◽  
Michele Malloy ◽  
Alison M. Steube ◽  

2000 ◽  
Vol 5 (5) ◽  
pp. 4-5

Abstract Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments for patients in whom abnormal illness behavior is absent but who have an objective basis for severe, persistent pain that has not been adequately relieved by other interventions. Usually, physicians prescribe these treatments in cancer pain or noncancer-related neuropathic pain settings. A survey of academic centers showed that 87% of responding centers use SCS and 84% use ISO. These treatments are performed frequently in nonacademic settings, so evaluators likely will encounter patients who were treated with SCS and ISO. Does SCS or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) does not specifically address this question, the answer follows directly from the principles on which the AMA Guides impairment rating methodology is based. Specifically, “the impairment percents shown in the chapters that consider the various organ systems make allowance for the pain that may accompany the impairing condition.” Thus, impairment is neither increased due to persistent pain nor is it decreased in the absence of pain. In summary, in the absence of complications, the evaluator should rate the underlying pathology or injury without making an adjustment in the impairment for SCS or ISO.


2010 ◽  
Author(s):  
W. M. Olango ◽  
S. M. Geranton ◽  
O. Moriarty ◽  
M. Roche ◽  
S. P. Hunt ◽  
...  

2003 ◽  
Vol 1 (2) ◽  
pp. 198-207
Author(s):  
H. Mabel Preloran ◽  
Silvia Balzano

This paper explores the emotional world of a recent Mexican immigrant who lives in Los Angeles and is awaiting the results of the amniocentesis she has ambivalently agreed to. She is 45 years old and has given birth to two children with severe disabilities and two who are apparently normal. We focus our analysis on the woman's reactions and feelings during the nine days she spends waiting for the test results. We show that the standard prenatal genetic clinical protocol aimed at providing medical education and requiring professional neutrality and emotional detachment left the woman feeling rejected and subsequently unwilling to seek information or support from her clinicians. We find that while the intent of a protocol of neutrality is to enable patients to make informed decisions without feeling pressure from clinicians, some women want greater emotional engagement. We argue that professional neutrality can inhibit patient-clinician communication, hamper medical education, and ultimately detract from patients' ability to make informed medical choices. / El presente artículo explora el mundo emocional de Rocío, una inmigrante mexicana, quien se encuentra esperando los resultados de una amniocentesis que aceptó hacerse, a pesar de las dudas sobre la credibilidad y utilidad de la misma. Rocío, de 45 años, tenía ya otros hijos, dos con anormalidades severas y dos aparentemente sanos. Centramos nuestro análisis en los sentimientos y reacciones durante los nueve días que transcurren mientras espera el diagnóstico. En este trabajo mostramos cómo la forma de presentar la información médica puede llegar a entorpecer la toma de decisión de un paciente. El protocolo genético tiene por meta proveer información médica manteniendo una cierta distancia profesional y emocional. Estas condiciones hacen que, en nuestro estudio de caso, la paciente se sienta rechazada y sin deseos de acercarse al personal médico, ya sea en busca de apoyo emocional o información que aclararía sus dudas. Creemos que, mientras el objetivo de la neutralidad profesional es asegurar que el paciente decida con los conocimientos adecuados y, a la vez, sin sentirse presionado, algunas mujeres preferirían un mayor acercamiento emocional por parte del personal médico cuando deben decidir sobre pruebas o tratamientos. Creemos que la neutralidad profesional puede llegar a inhibir la comunicación médico-paciente, dificultar la comprensión de la información y, por último, obstaculizar la habilidad de tomar decisiones informadas por parte de los pacientes.


2019 ◽  
Vol 15 (68) ◽  
pp. 091
Author(s):  
V. D. Pariy ◽  
S. M. Hryshchuk ◽  
N. M. Korneychuk ◽  
A. M. Harlinska ◽  
L. V. Horokhova

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